Prenatal Diagnosis of a Giant Foetal Lymphangioma and   Haemangiolymphoma in the Second Trimester Using 2D and 3D Ultrasound

C. Mittermayer; W. Blaicher; J. Deutinger; G. Bernaschek; A. Lee

doi:10.1055/s-2003-45218

Ultraschall in der Medizin, Table of Contents

Ultraschall Med 2003; 24(6): 404-409
DOI: 10.1055/s-2003-45218

Originalarbeit

Prenatal Diagnosis of a Giant Foetal Lymphangioma and Haemangiolymphoma in the Second Trimester Using 2D and 3D Ultrasound

Pränatale Diagnostik eines großen fetalen Lymphangioms und eines Hämangiolymphangioms im 2 Trimenon mitteld 2D- und 3D-UltraschallC. Mittermayer¹ , W. Blaicher² , J. Deutinger² , G. Bernaschek² , A. Lee²

¹Department of Neonatology and Intensive Care, University Hospital of Vienna, Austria
²Department of Obstetrics and Gynaecology, Division of Prenatal Diagnosis and Therapy; University Hospital of Vienna, Austria

Abstract

Zusammenfassung

Lymphangiome sind gutartige Tumoren des lymphatischen Systems. Frühzeitige pränatale Diagnostik ist wichtig. Dies erlaubt eine Planung der Geburt, adäquate postpartale Versorgung des Kindes, Verbesserung der Prognose und einen frühzeitigen Schwangerschaftsabbruch im Falle einer ungünstigen Prognose. Wir berichten von 2 Fällen, einem Hämangiolymphangiom und einem Lymphangiom. Die 2D- und 3D-US-Charakteristiken werden präsentiert, die Differenzialdiagnosen, therapeutischen Optionen und die Prognose diskutiert.

Abstract.

Lymphangiomas are benign tumours of the lymphatic system. Early prenatal diagnosis is important to permit a planned delivery and provide adequate postnatal care. It thereby improves prognosis and allows the option of terminating the pregnancy if poor outcome is predicted. We report two cases, a giant haemangiolymphoma and a lymphangioma. 2D and 3D US findings are presented and differential diagnosis, therapeutic options and prognosis are discussed.

Schlüsselwörter

Hämangiolymphangiom - pränatale Diagnostik - Lymphangiom

Key words

Prenatal diagnosis - lymphangioma - Haemolymphangioma

Full Text

References

1 Mittermayer C. Lymphangioma/Lymphohaemangioma at 2nd trimester. 4D examination online. http://www.univie.ac.at/obgyn/prenatale_medizin/3d1.htm. 2002
2 Lee A, Deutinger J, Bernaschek G. Voluvision: Three-dimensional ultrasonography of foetal malformations. Am J Obstet Gynecol. 1994; 170 1312-1314
3 Lee A, Deutinger J, Bernaschek G. Three dimensional ultrasound: abnormalities of the foetal face in surface and volume rendering mode. Br J Obstet Gynecol. 1995; 102 302-306
4 Moore K L, Persaud T VN. The cardiovascular system. In: Moore KL, Persaud TVN, eds The Developing Human: Clinical Oriented Embryology. Philadelphia: W.B: Saunders 1993: 349-351
5 Fonkalsrude E W. Congenital malformation of the lymphatic system. Semin Pediatr Surg. 1994; 3 62-69
6 Allason J E. Lymphatic circulation. In: Stevenson RE, Hall JG, Goodman RS, eds Human Malformation and Related Anomalies. New York: Oxford University Press 993: 293-304
7 Benacerraf B R. Syndrmes. In: Benacceraf BR, ed Ultrasound of Foetal Syndroms. Philadelphia: Churchill Livingston 1998: 343-349
8 Shah K D, Chervenak F A, Marchevsky A M, Rosenberg J C, Berkovitz R L. Foetal giant haemangiolymphangioma: Report of a case. Am J Perinatol. 1987; 4 212-214
9 Giacalone P L, Boulot P, Marty M, Deschmps F, Laffargue F, Viala J l. Foetal haemangiolymphoma: A case report. Foetal Diagn Therapie. 1993; 8 338-340
10 Kaminopetros P, Jauniaux E, Weston M, Nicolaides K H, Campell D J. Prenatal diagnosis of an extensive foetal lymphangioma using ultrasonography, magnetic resonance imaging and cytology. Br J Radiol.. 1997; 70 750-753
11 Romero R, Jeanty P, Ghidini A, Hobbins J. Prenatal Diagnosis of Congenital Anomalies. Cystic Hygroma. Norwalk, Connecticut: Appleton Lange 1988
12 Ogita S, Tsuto T, Nakamura K, Deguchi E, Iwai N. OK-432 therapy in 64 patients with lymphangioma. J Pediatr Surg. 1994; 29 784-785
13 Ogita S, Tsuto T, Nakamura K, Deguchi E, Iwai N. OK-432 therapy for lymphangiomas in children: why and how does it work?. J Pediatr Sirg. 1996; 31 477-480
14 Schmidt B, Schimpl G, Hollwarth M E. OK-432 therapy of lymphangiomas in children. Eu J Pediatr. 1996; 155 649-652
15 Ogita K, Suita S, Taguchi T, Yamanouchi T, Masumoto K, Tsukimori K, Nakano H. Outcome of foetal cystic hygroma and experience of intrauterine treatment. Foetal Diagn Ther. 2001; 16(2) 105-110
16 Charabi B, Bretlau P, Bille M, Helmelund M. Cystic hygroma of the head and neck - a long-term follow-up of 44 cases. Acta Otolaryngol Suppl. 2000; 543 248-250
17 Singh R K, Gutman M, Bucana C D, Sanchez R, Llansa R K, Fidler I J. Interferons α and β downregulate the expression of basic fibroblast growth factor in human carcinomas. Proc Natl Acad Sci. 1995; 92 4562-4566
18 Klagsbrun M, D'Amore P A. Regulators of angiogenesis. Ann Rev Physiol. 1991; 53 217-239
19 White C W, Sondheimer H M, Crouch E C, Wilson H, Fan L L. Treatment of pulmonary haemangiomatosis with recombinant interferon alpha-2a. N Engl J Med. 1989; 320 1197-1200
20 Ezekowitz R AB, Mulliken J B, Folkman J. Interferon alpha-2a therapy for life-threatening hemangioma of infancy. N Engl J Med. 1992; 326 1456-1463
21 Ricketts R R, Hatley R M, Corden B J, Sabio H, Howell C G. Interferon alpha-2a for the treatment of complex haemangiomas of infancy and childhood. Ann Surg. 1994; 219 605-615
22 Hastings M M, Milot J, Barsoum-Homsy M, Hershon L, Dubois J, Leclerc J M. Recombinant interferon alpha-2a in the treatment of vision-threatening capillary hemangiomas in childhood. JAAPOS. 1997; 1 226-230
23 Garmendia G, Miranda N, Borroso S, Longchong M, Martinez E, Ferrero J, Porrero P, Lopez-Saura P. Regression of infancy haemangiomas with recombinant IFN-α2b. J Interferon Cytokine Res. 2001; 21 31-38
24 Merz E. DEGUM-Standards in Prenatal Level II Ultrasound Diagnosis (18 - 22 weeks of gestation). Ultraschall in Med. 2001; 22(5) 199

MD C. Mittermayer

University Hospital of Vienna · Department of Neonatology and Intensive Care

Währinger Gürtel 18-20 · 1090 Vienna · Austria ·

Phone: +43 1 40400 5572

Fax: +43 1 40400 3296

Email: christoph.mittermayer@gyn.akh.magwien.gv.at